碳酸镧咀嚼片联合帕立骨化醇对维持性血液透析患者血清钙、磷及骨密度的影响

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摘要目的探讨碳酸镧咀嚼片联合帕立骨化醇对维持性血液透析（MHD）患者血清钙、磷及骨密度的影响。方法选取2020年5月至2021年5月赣州市立医院收治的90 例MHD 患者，采用随机数字表法将其分为A 组（30 例）、B 组（30 例）与C 组（30 例）。 A 组予以碳酸镧咀嚼片，B 组予以帕立骨化醇，C 组予以碳酸镧咀嚼片和帕立骨化醇，均持续治疗1 个月。比较三组治疗前后的肾脏病生活质量评分（KDQOL-SF）、左髋关节的骨密度（BMD）、肱三头肌皮褶厚度（TSF）、中臀围（MAC）、钙、磷代谢指标水平、营养指标水平和不良反应总发生率。结果治疗后，C 组的KDQOL-SF 评分和BMD 高于A、B 两组，且高于治疗前，差异有统计学意义（P＜0.05）； A、B 两组患者治疗前后的KDQOL-SF 评分和BMD 比较，差异无统计学意义（P＞0.05）；治疗后，C 组的TSF、MAC 均大于A、B组，且大于治疗前，差异有统计学意义（P＜0.05）；A、B 两组患者治疗前后的TSF、MAC 比较，差异无统计学意义（P＞0.05）；治疗后，三组患者的血钙水平比较，差异均无统计学意义（P＞0.05）；三组治疗前后的血钙水平比较，差异均无统计学意义（P＞0.05）；治疗后C 组的血磷低于治疗前，且低于A、B 组，差异有统计学意义（P＜0.05）；C 组治疗后的肌酐水平低于A、B 组，白蛋白水平高于A、B 组，三组治疗后的肌酐水平低于治疗前，白蛋白水平均高于治疗前，差异有统计学意义（P＜0.05）；三组患者的不良反应总发生率比较，差异无统计学意义（P＞0.05）。结论碳酸镧咀嚼片联合帕立骨化醇能有效改善MHD 患者的血磷及骨密度水平，并能有效改善其营养状况及生活质量。

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关键词 ：碳酸镧咀嚼片, 帕立骨化醇, 血清钙、磷, 骨密度, 维持性血液透析

Abstract：Objective To investigate the influence of Lanthanum Carbonate Chewable Tablets combined with Paricalcitol on serum calcium, phosphorus and bone mineral density in patients with maintenance hemodialysis (MHD). Methods A total of 90 patients with MHD confirmed from May 2020 to May 2021 in Ganzhou Municipal Hospital were enrolled. They were divided into group A (30 cases), group B (30 cases) and group C (30 cases) by random number table method. Group A was given Lanthanum Carbonate Chewable Tables, group B was given Paricalcitol, and group C was given Lanthanum Carbonate Chewable Tables combined with Paricalcitol. All patients were continuously treated for 1 months. The score of kidney disease quality of life short form (KDQOL-SF), left hip joint bone mineral density (BMD),triceps skin fold thickness (TSF), mid-arm muscle circumference (MAC), calcium and phosphorus metabolism indexes,nutritional indexes and the total incidence of adverse reactions were compared among three groups before and after treatment. Results After treatment, the KDQOL-SF scores and BMD in group C were higher than those in group A and group B, and which were higher than those before treatment, the differences were statistically significant (P＜0.05).There were no significant differences in the KDQOL-SF scores and BMD between group A and group B before and after treatment (P＞0.05). After treatment, TSF and MAC in group C were greater than those in group A and group B, and which were larger than those before treatment, the differences were statistically significant (P＜0.05). There were no significant differences in TSF and MAC between group A and group B before and after treatment (P＞0.05). After treatment, there was no statistically significant difference in blood calcium levels between the three groups and before and after treatment (P＞0.05). After treatment, blood phosphorus in group C was lower than that before treatment, and which were lower than those in group A and group B, the differences were statistically significant (P＜0.05). The creatinine level in group C after treatment was lower than that in group A and group B, the albumin level in group C after treatment was higher than that in group A and group B, and the creatinine levels in the three groups after treaatment were lwer than those before treatment, the albumin levels in the three groups after treatment were higher than those before treatment, the differences were statistically significant (P＜0.05). There were no significant difference in the total incidence of adverse reactions among the three groups (P＞0.05). Conclusion The Lanthanum Carbonate Chewable Tablets combined with Paricalcitol can effectively improve the levels of serum phosphorus, BMD, and can effectively improve nutritional status and quality of life in patients undergoing MHD.

Key words： Lanthanum Carbonate Chewable Tablet Paricalcitol Serum calcium and phosphorus Bone mineral density Maintenance hemodialysis

基金资助:江西省卫生健康委科技计划项目

引用本文:

张辉林；周琳君；吴田珠；张德生；刘勇；毛青华；郭全福；华瑞芳. 碳酸镧咀嚼片联合帕立骨化醇对维持性血液透析患者血清钙、磷及骨密度的影响[J]. 中国当代医药, 2022, 29(13): 73-76转80.
ZHANG Huilin ZHOU Linjun WU Tianzhu ZHANG Desheng LIU Yong MAO Qinghua GUO Quanfu HUA Ruifang. Influence of Lanthanum Carbonate Chewable Tablets combined with Paricalcitol on serum calcium, phosphorus and bone mineral density in patients with maintenance hemodialysis. 中国当代医药, 2022, 29(13): 73-76转80.

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https://www.dangdaiyiyao.com/CN/ 或 https://www.dangdaiyiyao.com/CN/Y2022/V29/I13/73

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